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Mapping the delivery of interventions for vaccine-preventable infections in pregnancy in Victoria, Australia
Nafisa Yussf1, Nicole Allard1, Nicole Romero2
1WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia; and Department of Infectious Diseases, University of Melbourne, Melbourne, Vic. 3000, Australia.
Insights
Perinatal services for preventing influenza, pertussis, and hepatitis B in pregnant women and infants face barriers. Improvements in standardized care, training, and communication are needed for equitable vaccine-preventable disease prevention.
Area of Science:
- Perinatal health
- Vaccine-preventable disease prevention
- Public health services
Background:
- Standard perinatal care includes screening for hepatitis B and vaccinations for influenza and pertussis.
- Infant hepatitis B vaccination is also a standard component of perinatal care.
- This study examines the delivery of these preventative services in Victoria, Australia.
Purpose of the Study:
- To explore the delivery of perinatal services for preventing influenza, pertussis, and hepatitis B.
- To identify barriers to optimal care for these vaccine-preventable diseases in pregnant women and infants.
- To assess current practices in Victoria, Australia.
Main Methods:
- Two online surveys were conducted between January and June 2021.
- The Birthing Hospitals Survey collected facility-level data on vaccination and hepatitis B prevention services.
- The Healthcare Providers Survey gathered individual staff perceptions and knowledge.
Main Results:
- Half of birthing hospitals offered influenza (50%) and pertussis (53%) vaccinations to pregnant women.
- 53% provided infectious disease services for women with chronic hepatitis B (CHB).
- Barriers included reliance on self-report, lack of standardized reporting, inadequate training, poor communication, and inconsistent guideline-based care; some facilities experienced hepatitis B immunoglobulin stock-outs.
Conclusions:
- Coordinated and standardized improvements are necessary for equitable perinatal care.
- Enhanced training and education for healthcare providers are crucial.
- Improved data capture and inter-service communication are required for better prevention of vaccine-preventable diseases.
Background:
Standard care for pregnant women includes universal screening for hepatitis B, and administration of influenza and pertussis vaccination to women and hepatitis B infant vaccination. This study explored how perinatal services relating to the prevention of these vaccine-preventable diseases are delivered to women and their infants in Victoria, Australia.
Methods:
Two online surveys investigated service delivery for the prevention of influenza, pertussis and hepatitis B to identify barriers to optimal care during January-June 2021; (1) The Birthing Hospitals Survey captured facility-level information about service delivery for influenza and pertussis vaccination, and interventions to prevent mother-to-child-transmission of chronic hepatitis B (CHB); and (2) The Healthcare Providers Survey captured individual staff perceptions and knowledge in community and hospital settings.
Results:
Thirty-four hospital unit managers (61%) completed The Birthing Hospitals Survey . One-hundred and forty participants completed The Healthcare Providers Survey . Half of the birthing hospitals provided influenza (50%) and pertussis (53%) vaccinations to pregnant women, and 53% provided an infectious diseases service for women with CHB. Barriers to optimal care delivery included reliance on pregnant woman's self-report to confirm influenza, pertussis vaccination and CHB status, lack of standardised reporting, inadequate workforce training, poor communication between services, and lack of guideline-based clinical care for mothers with CHB and their infants. Three hospitals reported 'stock out' of hepatitis B immunoglobulin (HBIG).
Conclusion:
Coordinated and standardised system and clinical care improvements are required to provide equitable care for pregnant women and their infants, including training and education for healthcare providers, improving data capture and communication among health services.
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